Octreotide
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Lack of efficacy: case report A 63-year-old man exhibited lack of efficacy during treatment with octreotide for neuroendocrine tumour (NET). The man had been diagnosed with highly differentiated functional NET of the ileum and synchronous liver metastases in July 2016. He started receiving treatment with somatostatin analogue (SAA) comprising octreotide depot 30mg long acting release (LAR) every 28 days in August 2016 [route not stated]. In November 2016, he was found to have progression of disease along with tumour progression in the liver. To avoid a potentially life-threatening small bowel obstruction, he was hospitalised and underwent laparascopic right-sided hemicolectomy along with right sided ureterolysis. Intraoperatively, peritoneal lesions were noted, which turned out as metastases of a neuroendocrine tumour. These findings indicated peritoneal carcinomatosis. Considering the progression of his condition, a schedule of SAA was shortened to octreotide depot 30mg LAR every 21 days to increase its efficacy. But, his general condition was found to be deteriorated. He developed diarrhoea, flush symptoms along with remarkable weight loss. Later on, he had revealed hepatic tumour progression, along with an elevation in chromogranin A and 5-HIAA concentrations. Thereafter, it was decided to initiate add on therapy with interferon-α considering other alternative options were not available due to negative expression of somatostatin receptor in liver metastases. Considering high hepatic tumour burden locoablative procedures were not performed. As he had better tolerability in comparison to conventional interferon, he was started on peginterferon-α 2a [PEGylated interferon alpha 2a], which was no specifically approved for NET. Eventually, following 30 months of this treatment, his condition was excellent with sustained tumour response. Also, he became free from any symptoms related to hormone hypersecretion. Ozdirik B, et al. A case report of an excellent response to interferon- alpha in a patient with functional metastasized neuroendocrine tumor refractory to other treatments. 803496911 Medicine 99: e20820, No. 25, 19 Jun 2020. Available from: URL: http://doi.org/10.1097/MD.0000000000020820
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Reactions 22 Aug 2020 No. 1818
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